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Peripheral Vascular Disease
 

  Introduction

Peripheral vascular disease is a form of atherosclerosis,  a hardening of the arteries, and is a progressive disease process.  It can result in blockages in arteries of the brain, arms, kidneys,  and legs. Atherosclerosis is caused when fatty substances build  up inside the artery walls over time and create an occlusion  which restricts proper blood flow. In the peripheral or non-heart vessels, this is most likely to occur in the iliac arteries (lower abdomen  leading to the legs), the femoral and popliteal arteries (legs),  the renal arteries (kidneys) and the carotid arteries (in the  neck leading to the brain) and subclavian arteries (arms).

You will find answers here to some questions you may have  about peripheral vascular disease and its treatment alternatives.  Please realize, however, that everyone's situation may be different  and may vary slightly from what is described here. Please feel  free to contact us and express your questions at any time.

 

Disease Symptoms

When organs and muscles in the body receive an insufficient  supply of oxygen-rich blood, they literally become starved and  alert you to this fact by producing pain. If the blockage occurs  in the arteries supplying the legs, the resulting symptom is  a cramping pain in the hips, thighs or calf muscle and can limit  even casual walking. If the pain is relieved with rest, we call  this condition "intermittent claudication ". If blood circulation becomes so severely restricted that  the legs and feet are perpetually starved for nutrition, gangrene -- death of the  tissue -- can occur. Without treatment, the entire  foot or possibly part of the leg may have to be amputated However if discovered in time an appropriate treatment regime may be possible to avoid this devastating event!.

Illiac artery stent

Renal Artery Angioplasty

Other symptoms of peripheral vascular disease in the lower  extremities include: coldness of the leg and foot; paleness of  the leg or foot if elevated; blue/red discoloration of the foot  or toes; dry, fragile or shiny-looking skin; numbness, tingling  or pain in the leg, foot or toes; and sores that do not heal. Symptoms of peripheral vascular disease in the renal arteries  include hypertension (high blood pressure) - consistently higher  than 160/100 despite adequate medication therapy and/or abnormal kidney function blood tests.

Stented Carotid Artery 

Symptoms of peripheral vascular disease in the carotid arteries  include: sudden, temporary weakness or numbness of the face,  arm and/or leg on one side of the body; temporary loss of speech  or trouble speaking or understanding speech; temporary dimness  or loss of vision, particularly in one eye; and unexplained dizziness,  unsteadiness or sudden falls. Transient Ischemic Attacks (TIA's) or mini-strokes illicit the same symptoms named above except  they are temporary. New advances in the treatment of blockages of the carotid arteries include balloon angioplasty and stent implantation. It must  be stated, however, that only surgery of these diseased blood vessels has  been approved to date. Nevertheless, Dr. Neil E. Strickman is an FDA approved investigator for patients who may be candidates for Carotid Stenting.

Other conditions can also cause these symptoms. Therefore,  a thorough examination with a physician is necessary.

Diagnosis

When any of the above-named symptoms occur, a history and  physical examination accompanied by an ultrasound Doppler test  are initially performed. The ultrasound Doppler test provides an image of  the inside of the arteries using sound waves  to determine if there is plaque buildup, and if so, to what extent.  This test is simple,  painless, and can be performed as an outpatient  procedure in the Cardiologist's office.

If the test shows that the stenosis (or narrowing of the artery)  is severe, then a test called an arteriogram or angiogram will  give your physician the complete information he or she needs  to properly diagnosis your condition.

 

Treatment Alternatives

Many treatments can be used to improve blood flow through  the peripheral arteries. The latest interventions for treating  peripheral vascular disease can bring swift relief and are more cost effective than surgery. Most procedures are performed on an outpatient basis or require no more than an overnight hospital stay, whereas patients enjoy an early return to most normal activities. Techniques now available to you include:  the use of balloon catheters, stents, stent-grafts, atherectomy, and laser assistance.  All these alternatives treat the build-up of plaque by either  removing it, compressing it or displacing it. During these procedures  the physician will periodically inject a contrast dye and take  x-ray pictures to determine whether or not the artery is sufficiently  opened. If the blockage is extremely long or has become very  hard and calcified with time, it may be resistant to any of these  interventions. In these cases, surgery may be required to bypass  the problem area.

 © 1998, 2000, 2002, 2003, 2004, 2005, 2006, 2007, 2008  by Hall-Garcia  Cardiology Associates - Last revised March 12, 2008

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